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[十二指肠溃疡择期毕Ⅱ式胃切除术后的发病率和死亡率。作者的经验]

[Morbidity and mortality after elective Billroth II gastric resection in duodenal ulcer. Authors' experience].

作者信息

Pezzolla F, Guerra V, Lorusso D

机构信息

Divisione di Chirurgia, Istituto Scientifico Gastroenterologico S. De Bellis Castellana Grotte, Bari.

出版信息

Minerva Chir. 1993 Feb;48(3-4):123-6.

PMID:8479645
Abstract

A retrospective study was carried out those patients who underwent elective Billroth II gastric resection for pyloric or duodenal ulcer at the Surgical Division of the Scientific Institute of Gastroenterology of Castellana Grotte between 1974 and 1989. The aim of the study was to asses the incidence of postoperative morbidity and mortality. A total of 526 patients were included in the study (mean age 49 years +/- 12 years; 451 males (86%) and 75 females (14%). Morbidity was 20.7% and mortality 1.5%. These findings are in line with those reported in the literature and confirm that gastric resection for duodenal ulcer, even when performed electively, has a far from negligible morbidity and mortality rate. It is well known that, in comparison to more conservative operations such as vagotomy, gastric resection for peptic ulcer presents a high rate of postoperative morbidity and mortality, but a lower incidence of ulcerous recidivation. Unless there are valid preoperative criteria on which to base the choice of one or other techniques, the surgeon will usually choose the method with which the is most familiar. until studies have been carried out to identify the risk factors leading to postoperative morbidity and mortality, the authors suggest that gastric resection is reserved for those patients presenting a low operative risk.

摘要

对1974年至1989年间在卡斯特拉纳格罗特胃肠病科学研究所外科接受选择性毕罗Ⅱ式胃切除术治疗幽门或十二指肠溃疡的患者进行了一项回顾性研究。该研究的目的是评估术后发病率和死亡率。共有526例患者纳入研究(平均年龄49岁±12岁;451例男性(86%)和75例女性(14%))。发病率为20.7%,死亡率为1.5%。这些结果与文献报道一致,并证实十二指肠溃疡的胃切除术即使是选择性手术,其发病率和死亡率也远非可以忽略不计。众所周知,与诸如迷走神经切断术等更为保守的手术相比,消化性溃疡的胃切除术术后发病率和死亡率较高,但溃疡复发率较低。除非有有效的术前标准作为选择一种或另一种技术的依据,外科医生通常会选择自己最熟悉的方法。在进行研究以确定导致术后发病率和死亡率的危险因素之前,作者建议胃切除术仅适用于手术风险较低的患者。

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